摘要
目的评估替加环素在儿童重症感染中的有效性和安全性。方法以2012年5月1日至2017年4月30日浙江大学医学院附属儿童医院收治的114例重症感染患儿作为研究对象。纳入标准:接受替加环素治疗2 d及以上。记录患儿的基本病史、用药信息和实验室检查结果。结果 114例中有47例多重耐药鲍曼不动杆菌感染的病例,培养出52株鲍曼不动杆菌菌株。病死率23.4%(11/47)。47例中,替加环素治疗中位时间是13 d[(2.5～13.5)d],替加环素治疗前其他抗生素使用的中位时间是9 d[(2～27)d]。总体临床好转率47.3%,病原学清除率38.9%。47例鲍曼不动杆菌感染病例,替加环素治疗结束时有24例临床好转,26株菌株被清除。治疗过程中未见严重副反应。结论有近半数病例得益于替加环素治疗,但替加环素的有效性不可被高估。需要更多的对照控制研究来进一步论证替加环素治疗的有效性和安全性。
Objective To evaluate the efficacy and safety of tigecycline therapy in children with severe infection.Methods We conducted a restrospective chart review of 114 children with severe infection in a tertiary hospital from May 1,2012 to April 30,2017. Inclusion criteria: receiving tigecycline administration for at least 2 days(4 doses). Clinical data and laboratory results were recorded before and after the therapy. Results Totally 114 children were enrolled,including 47 patients diagnosed with Acinetobacter baumanmii infection,with 52 Acinetobacter baumanmii strains. The in-hospital mortality was 23.4%. Median duration of tigecycline treatment was 13 days(2.5-13.5 days). Median duration of antibiotics prior to tigecycline treatment was 9 days(2-27 days). The total clinical improvement rate was 47.3%,and the etiological eradication rate was 38.9%. After treatment 24 cases got clinically improved in 47 patients and 26 strains were eradicated. No serious adverse effect was reported. Conclusion The efficacy and safety of tigecycline should not be overvalued. Additional data from randomized controlled trials are required to assess the administration of tigecycline.
作者
林舒鹏
张晨美
叶盛
UN Shit-peng;ZHANG Chen-mei;YE Sheng(Zhejiang University School of Medicine Children's Hospital, Division of Hematology-Oncology, Hangzhou 310003,China)
出处
《中国实用儿科杂志》
CSCD
北大核心
2019年第3期212-217,共6页
Chinese Journal of Practical Pediatrics
基金
浙江省医药卫生科技计划项目(2012KYB119)
浙江省医药卫生科技计划项目(2019KY437)
浙江省自然科学基金(LY12H19006)
关键词
替加环素
重症感染
儿童
鲍曼不动杆菌
多重耐药
tigecycline
infection
child
Acinetobacter baumannii
multi-drug resistant
